Clinical and Molecular Virology Unit, University Hospital and EA-4303 Faculty of Medicine, Reims, France.
J Clin Virol. 2011 Oct;52(2):142-5. doi: 10.1016/j.jcv.2011.06.017. Epub 2011 Jul 28.
Human Herpesvirus 6 (HHV-6) is an important cause of fulminant or acute viral myocarditis in immunocompromised or immunocompetent patients. However the physiopathological mechanisms of HHV-6 related acute myocarditis and the involvement of subsequent HHV-6 reactivation phases in the development of chronic cardiomyopathies remain to be assessed.
To describe a case of fatal HHV-6 chronic myocarditis in an immunocompetent adult.
Case report and detailed histological and viral diagnoses by combination of histology/immunohistochemistry and polymerase chain reaction techniques on cardiac tissues.
Histopathological analysis of ventricular tissues showed large interstitial and scarring fibrotic areas with a moderate mononuclear cell infiltrate compatible with histological aspect of chronic myocarditis. Detection of both HHV-6 by real-time PCR and viral glycoproteins in mononuclear and endothelial cells by immunohistochemistry evidenced an ongoing cardiac HHV-6 replication with viral late protein synthesis activity.
This case report indicates that HHV-6 can establish a chronic active myocarditis leading to heart failure in immunocompetent subjects.
人类疱疹病毒 6（HHV-6）是免疫功能低下或免疫功能正常的患者发生暴发性或急性病毒性心肌炎的重要原因。然而，HHV-6 相关急性心肌炎的病理生理机制以及随后的 HHV-6 再激活阶段在慢性心肌病发展中的作用仍有待评估。
描述一例免疫功能正常的成人致命性 HHV-6 慢性心肌炎病例。
对心脏组织进行组织学/免疫组织化学和聚合酶链反应技术相结合的详细组织学和病毒学诊断的病例报告。
心室组织的组织病理学分析显示，间质和瘢痕纤维化区域较大，伴有中等程度的单核细胞浸润，符合慢性心肌炎的组织学表现。实时聚合酶链反应检测到 HHV-6 和免疫组织化学检测到单核细胞和内皮细胞中的病毒糖蛋白表明存在持续的心脏 HHV-6 复制和病毒晚期蛋白合成活性。
本病例报告表明，HHV-6 可在免疫功能正常的患者中引发慢性活动性心肌炎，导致心力衰竭。
